New technique combined with suture and incision method for creating a more physiologically natural double-eyelid

Plast Reconstr Surg. 2010 Jan;125(1):324-331. doi: 10.1097/PRS.0b013e3181c496c5.


Background: A combination of incision and nonincision surgical approaches is necessary to create a more physiologically natural double-eyelid.

Methods: The location of the partial incision and the burying location are determined. Through a partial incision, the levator aponeurosis is isolated and fixed to the tarsal plate. A single-knot continuous suture is performed. The location of the continuous suture passing through the tarsal plate is at a level that is slightly lower than that at which the levator aponeurosis is fixed to the tarsal plate.

Results: A total of 562 patients were operated on from November of 2006 through October of 2008. The double-eyelid operation was performed on 386 patients, the upper blepharoplasty with skin excision was performed in 91 patients, and a secondary operation was performed in 85 patients. Combined mild to moderate blepharoptosis was corrected simultaneously in all cases. The follow-up period ranged from 6 months to 2 years. Individual patient recovery time varied from 2 weeks to 2 months.

Conclusions: The advantages of the authors' technique are as follows: (1) the process of forming a double-eyelid is natural; (2) the power of the levator palpebrae muscle regarding the eye-opening process is transmitted to pull up the entire lid margin, allowing the eyes to be easily opened with minimal effort; and (3) there is minimal surgical scarring when the eyes are closed.

MeSH terms

  • Adult
  • Asians
  • Blepharoplasty / methods*
  • Cicatrix / prevention & control
  • Humans
  • Oculomotor Muscles / physiology
  • Postoperative Complications / prevention & control
  • Suture Techniques
  • Treatment Outcome